Provider Demographics
NPI:1871571315
Name:AMAYA, ROBERT JULIO (FNP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JULIO
Last Name:AMAYA
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 CHURCHILL DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-4287
Mailing Address - Country:US
Mailing Address - Phone:757-319-6673
Mailing Address - Fax:757-445-5443
Practice Address - Street 1:928 CHURCHILL DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-4287
Practice Address - Country:US
Practice Address - Phone:757-319-6673
Practice Address - Fax:757-445-5443
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253546363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily